Omega: How do you explain EMDR to someone who has never heard of it?
Laurel: EMDR stands for Eye Movement Desensitization and Reprocessing. It is an evidence-based trauma therapy that was developed in the mid-1980s by Francine Shapiro. We use alternating bilateral stimulation when someone has activated a traumatic memory. This sets off a rapid processing effect where what’s been frozen in the trauma network moves out of the nervous system.
Omega: What is bilateral stimulation?
Laurel: It’s literally a way of activating both sides of the brain. In the old days we just used eye movement, hence EMDR. But we can use auditory stimulation or tactile stimulation, like tapping someone on the outside of each leg if you’re sitting across from them or having them hold little pulsers in their hands.
Omega: Who can be helped by EMDR?
Laurel: It works for people who have been through big traumas like war or terrorist attacks—people who are likely to experience post-traumatic stress. It also works for things like early childhood traumas like abuse and neglect. There are also a lot of clinical applications for problems beyond the big traumas, like phobias and anxiety.
Omega: Are there people who shouldn’t try EMDR?
Laurel: Clients who are very unstable and are currently psychotic, self-harming, or completely flat, with no affect, are not well-suited to EMDR. Also clients who don’t respond well to bilateral stimulation or who are not motivated or willing to do the work to feel the feelings, like sociopaths—it doesn’t work for those people.
Omega: Does it work for adults and children?
Laurel: It works for both. The original protocols were created for adults, but we've developed modifications for the protocols to work with a range of clinical populations and ages.
Omega: What happens in a session?
Laurel: I use a very client-centered, relational approach that I call Attachment-Focused EMDR. We emphasize safety and the importance of the therapeutic relationship, so when a person comes in, we don’t start right off with EMDR. We get to know them and we work with stabilization techniques so they’re strong enough to handle the intensity of where we’re going.
I teach therapists to, over time, set their clients up with four foundational resources they can refer back to when they’re working through a traumatic memory: a peaceful place, nurturing figures, protector figures, and wise figures. We establish connections to these things before we work with the trauma so they can call them up during a session if they need to.
During the EMDR session itself, we start by asking the client what picture represents the worst part of the incident. Let's say it was a sexual assault, and they think of the image of the man’s face before he attacked them. We ask them to notice the sensations in their body and the thoughts and beliefs in their mind. We ask them where the intensity falls on a scale of zero to 10 and if they say it’s high, near 10, then we start the bilateral stimulation and they begin to process.
They may have strong feelings that go in waves and after a wave, we’ll pause with the bilateral stimulation. When another wave comes up we’ll start it again. One wave may be about anger, another may be that they’re feeling sad this happened to them. If they have other memories or associations we go with those, too. If they get stuck somewhere we say, “What do you need?” If they answer, “I need protection,” we have them bring in one of their resources, maybe the protector figure.
When we check back in with the original trauma and it’s way down on the scale of zero to ten, like a zero or a one, then we ask them what they believe about themselves now. They often say something like, “I feel strong, like I can take care of myself.” We have them pair that new belief with the traumatic incident and add bilateral stimulation to link them together.
Finally, we check in with the body and do a debriefing. We talk about what they processed and maybe they'll go back to their peaceful place and bring in their resource figures. We make sure that they're in their bodies and they feel good before they walk out the door.
The next time they come in we’ll ask how the week went and how they’re feeling. We’ll go back and check the scene we processed from the week before and, if that feels distant, we’ll look at something else that has come up, or we’ll just talk.
Omega: How will someone feel after an EMDR session?
Laurel: During the session, the client will have thoughts and feelings and body sensations move through them. At the end of the session, they’ll have a sense that what was distressing now feels like it's in the past. They have a more global view and understanding of what happened, and it will no longer feel like it's happening in the present, which is how people experience traumatic memories.
Omega: Is this something someone can do at home?
Laurel: EMDR is a therapist-guided therapy. However, if it feels right, and if the therapist and the client together decide this would be helpful for the client, they can use what I call Resource Tapping™ at home. I wrote about this in my book Tapping In, where I offer exercises like tapping the sides of your legs while you think of your peaceful place or your protecting figure or nurturing figure.
But we always offer the caveat to be careful. What you don’t want to do with bilateral stimulation is have it open up trauma networks that you can't manage on your own. Even if you're using bilateral stimulation on positive things, some people will flip very quickly into the negative and open up trauma material that can flood them.
Omega: Can EMDR be useful if you can’t remember your trauma?
Laurel: Absolutely. If somebody comes in and they say, "I had this bad car accident and now I'm afraid of driving," or “I witnessed this terrible event,” that's very simple and straightforward.
But if you have somebody who says, "I've got all this anxiety and I believe I was abused as a child but I don't have any memories," that requires greater skill on the therapist's part. Or perhaps someone has anxiety, depression, or phobias but doesn’t know where they come from. A skilled therapist can find what in the past is linked to the problems in the present.
Omega: How can someone find an EMDR-trained therapist?
Laurel: If they want an Attachment-Focused EMDR practitioner, they can look at the directory on my website: ParnellEMDR.com. There's also the EMDR International Association, a directory of practitioners who may not be attachment focused but who have done the full EMDR International Association approved training.
